Comparison of vaccination behavior and the 5C model of psychological antecedents of vaccination in the adult population

Comparison of Vaccination Behavior and the 5C Model of Psychological Antecedents of Vaccination in the Adult Population Introduction and Purpose: The World Health Organization defines vaccine hesitancy as a delay in the acceptance or rejection of vaccines despite their availability. Addressing public health issues like vaccine hesitancy is one of the primary responsibilities of family physicians. This study aims to examine the relationship between individuals' hesitancy regarding childhood, adult, and COVID-19 vaccines and vaccination intention, using the 5C model (confidence, complacency, constraints, calculation, and collective responsibility). Additionally, the study seeks to strengthen the role of primary healthcare services in managing vaccine hesitancy. Materials and Methods: This study was conducted through a cross-sectional survey between June 6, 2024, and September 3, 2024, with 438 randomly selected individuals aged 18–65 visiting the Family Medicine outpatient clinics of Ankara Bilkent City Hospital. The first section of the survey collected sociodemographic information and individuals' knowledge/hesitancy regarding vaccines, while the second section included the 5C scale. Statistical analyses and calculations were performed using IBM SPSS Statistics 21.0 and MS-Excel 2007. The significance level was set at p: 0.05. Results: Of the 438 participants, 53.2% (n=233) were female, and 46.8% (n=205) were male. 5.5% (n=24) had completed middle school or lower, 20.3% (n=89) were high school graduates, and 74.2% (n=325) had a bachelor's degree or higher. The average confidence score of healthcare workers was 5.34±1.39, while for other professions, it was 4.24±1.71. The confidence score for individuals who had hesitancy regarding childhood vaccines was 3.35±1.5, while those without hesitancy scored 4.53±1.77. Significant results were observed for those who believed adult vaccines were necessary and for those who had received the COVID-19 vaccine. Conclusion: This study shows significant relationships between vaccination intention and the psychological antecedents in the 5C model. Confidence, calculation, and collective responsibility were positively correlated with vaccination intention, while complacency and constraints had a negative correlation. Hesitancy regarding the COVID-19 vaccine was higher compared to other vaccines, with the primary concern being side effects. Healthcare workers had higher confidence levels, and as knowledge increased, vaccine uptake also increased. The 5C scale can be an effective tool for developing personalized information and persuasion strategies. Primary healthcare services should play a crucial role in this process. Keywords: Family practice, vaccination hesitancy, vaccination refusal